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This post was originally published on taylordenniswrites.com on April 21, 2021.
The year 2021 marks the 100th anniversary of the discovery of insulin. To celebrate a century of progress that began in one of its laboratories, the University of Toronto hosted a free virtual scientific symposium, Insulin100.
Last week, a certain blogger got a chance to write about all of this for T1D Exchange, a US-based non-profit focused on type 1 diabetes research. You can check that article out here.
In the process of writing this post for T1D Exchange and attending the virtual symposium, I learned a lot about the story of my favourite clear liquid. This work also got me thinking about another topic that’s been on my mind in light of the ultra-fast development of COVID-19 vaccines: the value of science.
But I’m getting ahead of myself. Let’s go back, for a moment, to the discovery of insulin.
The Discovery of Insulin
Even if you don’t rely on the stuff to live, the discovery of insulin makes for a great story. It goes a little something like this:
In fall of 1921, a Canadian physician named Frederick Banting wakes from a dream with a very, very good idea. He scribbles the idea into his notebook, then sets out to find a way to test it. He approaches J.J.R. Macleod, Professor of Physiology at the University of Toronto, who provides Banting with lab space and an assistant, student Charles Best.
In less than a year, Banting takes his idea from dreamy hypothesis to practical application. The first successful dose of insulin is administered in January of 1922 to a 14-year-old boy with type 1 diabetes, Leonard Thompson.
Nearly comatose, Thompson weighs only 65 pounds. He has been on a starvation diet for over two years to delay his inevitable demise. Desperate for a miracle, Thompson’s parents allow their dying son to be injected with Banting’s experimental new serum—and it works. Thompson’s blood sugar is lowered dramatically. With continued doses of the medication, he goes on to live another 13 years.
Banting, Best, and James Collip, a biochemist brought on to purify the original extract, sell the patents for their new serum for just $1 to the University of Toronto in an attempt to prevent commercial exploitation of the new life-saving drug. Banting utters his now famous quote: “Insulin does not belong to me; it belongs to the world.” Production of the miracle medication, now called insulin, is scaled up by labs and pharmaceutical companies across the world.
In 1923, Banting and MacLeod win the Nobel Prize in Medicine. The men split their prizes with the other two collaborators, Best and Collip.
And just like that, in the course of less than two years, type 1 diabetes goes from a terminal illness to a treatable condition. Millions of lives, present and future, are saved.
Taking a Closer Look
Everything written in the above account is true. But like all compelling, movie-worthy stories, it’s missing a lot of important details.
Take, for example, the fact that Banting’s initial idea wasn’t a random stroke of genius; it was inspired by existing research in the field, which he had been reading while preparing a lecture on the pancreas. Or the fact that Banting and Best worked side by side for months, testing and iterating on Banting’s original hypothesis together.
Also missing from the popular narrative of the discovery of insulin is the role played by J.J.R. Macleod. He was an experienced researcher who likely provided a great deal of practical guidance to Banting and Best. However, personal tensions between Banting and Macleod led to inconsistent, unreliable accounts about exactly who did what. A century later, it’s tough to accurately judge the true extent of Macleod’s involvement.
Consider also the important work contributed by biochemist James Collip, who purified Banting and Best’s serum. Before Collip joined the team, Leonard Thompson suffered a severe allergic reaction to his first dose of Banting and Best’s impure extract.
These details (and many others) aside, the truth remains that Banting, Best, MacLeod, and Collip took Banting’s original idea from inspiration to application in an incredibly short period of time.
Still, there was much more work to be done. The team had not yet perfected their method for extracting and purifying the serum from animal pancreases. Shortly after announcing their discovery, the team was temporarily unable to recreate the potency of their original extract. It would take many more scientists and a great deal more funding to create a reliable process that could be scaled up.
And, of course, the story of insulin does not end in the 1920s. Over the next century, researchers would continue to improve upon Banting’s original discovery. For one thing, today’s insulin is made from E. Coli bacteria—not extracted from animal pancreases. There have been many other important developments as well. If you’d like to learn more about evolution of insulin, I recommend Dr. Stewart Harris’s presentation from Insulin100.
If you don’t care much about the details, all you need to know is this: The insulin available in 1923 was immeasurably better than the previous option for people with type 1 diabetes (a starvation diet followed by an untimely death), and insulin today is immeasurably better than the insulin produced a century ago.
Thank You, Scientists
One hundred years ago, Banting and his colleagues made history. This past week, as I perused Insulin100 presentations given by physicians and researchers from around the world, I was reminded that the story of insulin isn’t over yet.
Immune therapies for preventing type 1 diabetes, closed-loop insulin systems for tighter blood sugar control, research on gut microbes, and so much more . . . though my comprehension of this research barely scrapes the surface, I still understand it well enough to know that scientists all over the world are dedicating their professional lives to making my life better.
I am not naïve; I know that medical research is a for-profit industry driven by dollars and cents, not altruism. I also do not wish to downplay issues of access and cost, topics that are impossible to ignore when it comes to the topic of insulin. Yet in spite of the politics, I am inspired by the science and the individuals responsible for moving it forward.
Insulin is ultimately the product of human curiosity and perseverance. Its discovery and continued improvement is the result of many, many people refusing to settle for “good enough.” In other words, it is the product of science.
Science has a way of getting tangled up in the overwhelming shuffle of politics and money. And with so much information available—much of it ostensibly about science, but actually about the other two topics—it’s no wonder misinformation has become so prevalent. For reasons both understandable and dubious, trust in science has eroded alongside trust in political parties and leaders, and fear has taken its place.
In researching the history of insulin, including the complicated realities of medical research, healthcare access, and more, I was reminded that beneath all the complexity is the simple truth that ethical science can do us so much good if we value it appropriately.
Imagine what would have happened if, in 1923, parents of children with type 1 diabetes hadn’t trusted Banting or his miraculous new medication. Imagine if they’d read Leonard Thompson’s story in the newspaper and not believed it was true. What would the world look like if, over the past century, we had rejected science instead of embracing it?
I am grateful for the science behind insulin and so many other innovations of the past 100 years. And, of course, for the scientists who drove it forward.
Thank you, scientists. Thank you for insulin, antibiotics, vaccines, clean water, an ample food supply, and all the other wonderful things that have kept me alive so far. Thank you for electricity, bridges, cars, the internet, telephones, music, movies, and so much more.
Thank you for allowing all of us – scientists or not – to live in and create a better world.
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